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M/S 3 > Exam 2 - cardiac disorders > Flashcards

Exam 2 - cardiac disorders Flashcards

1
Q

what is cardiac tamponade (pericardial effusion)

A

accumulation of fluid in the pericardial sac

causes extreme pressure on the heart, prevents ventricles from fulling expanding

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2
Q

s/sx of cardiac tamponade (pericardia effusion)

A

CP
confusion
anxiety
restlessness
tachycardia (d/t low CO)
tachypnea (d/t low CO)
JVD
muffled heart sounds
narrow PP

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3
Q

Becks Triad r/t cardiac tamponade complications

A

low BP
muffled heart sounds
JVD

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4
Q

Becks Triad can lead to what emergency procedure

A

pericardiocentesis

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5
Q

what is cardiomyopathy

A

diseased heart muscle
heart is enlarged and thickened

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6
Q

what are the 3 types of cardiomyopathy

A

dilated
hypertrophic
restrictive

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7
Q

cardiomyopathy causes a ___ in pumping ability which leads to ___ ___; eventually leading to ___ backing up into the ___

A

decrease
heart failure
blood; lungs

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8
Q

most common type of cardiomyopathy

A

dilated

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9
Q

what occurs with dilated cardiomyopathy

A

ventricle dilation
impaired systolic function
enlarged atrium
blood stasis in L ventricle
diminished ctx of muscle fibers
myocardial cell necrosis

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10
Q

causes of dilated cardiomyopathy

A

pregnancy
HTN
alcohol abuse
viral infections
chemo meds
myexedema
persistent tachycardia
thyrotoxosis
Chagas disease

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11
Q

s/sx of dilatedcardiomyopathy

A

dyspnea at rest
orthopnea
N/V/A
crackles
edema
JVD
weak peripheral pulses
stasis, clots

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12
Q

s/sx of dilated cardiomyopathy as disease progresses

A

dry cough
palpitations
N/V/A
bloating

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13
Q

dilated cardiomyopathy treatment

A

tx underlying disease
HF
ventricular support device
transplant
home health
hospice

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14
Q

leading cause of dilated cardiomyopathy death

A

ventricular dysrhythmias

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15
Q

what is hypertrophic cardiomyopathy

A

autosomal dominant genetic disorder

increase heart muscle size and mass

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16
Q

is hypertrophic cardiomyopathy a systolic or diastolic dysfunction

A

diastolic from L ventricle stiffness

decrease ventricle filling = decrease CO (especially during exertion)

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17
Q

when is hypertrophic cardiomyopathy usually dx

A

young adults and athletic individuals

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18
Q

what is the most common cause of death in otherwise healthy individuals

A

hypertrophic cardiomyopathy

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19
Q

what is restrictive cardiomyopathy

A

diastolic dysfunction caused by rigid ventricular walls that impair diastolic filling and ventricular stretch

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20
Q

what are the 4 types of restrictive cardiomyopathy

A

infiltrative disease
storage disease
non-infiltrative
endomyocardial

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21
Q

causes of restrictive cardiomyopathy

A

myocardial fibrosis
hypertrophy
amyloidosis
endocardial fibrosis
radiation to throax

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22
Q

generalized s/sx of cardiomyopathy

A

CHF s/sx
CP
palpitations
dizziness
nausea
syncope with exertion

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23
Q

reasons for a heart transplant

A

cardiomyopathy
ischemic heart disease
valve disease
congenital heart defect
rejection of previous heart transplant

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24
Q

most common procedure for heart transplant

A

orthotropic transplantation (bicaval technique)

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25
Q

what occurs with orthotropic transplantation (bicaval technique)

A

receipients heart is removed, portion of atria is left in place with vena cava and pulmonary veins

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26
Q

3 post-transplant drug classes

A

corticosteroids (prednisone)
calcineurin inhibitors (tacrolimus, cyclosporine)
antiproliferative (mycophenolate, mofetil, azathioprine, sirolimus)

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27
Q

post-transplant medication risk factors

A

skin, lip cancer
weight gain, obesity
DM
dyslipidemia
kidney failure
HTN
GI disturbances
respiratory problems
medication toxicity

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28
Q

heart transplant complications

A

HTN
risk for osteoporosis
infection
rejection (quickly - years later)

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29
Q

psychosocial issues r/t heart transplant

A

increase quality of life
fear of heart rejection
feelings of guilt
indebtness to donor

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30
Q

can a person experience angina post heart transplant

A

No d/t to nerve connection

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31
Q

are atropin and digoxin effective after a heart transplant

A

No

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32
Q

what does a ventricular assist device (VAD) do

A

circulates as much blood per minute as the heart

can be internal or external

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33
Q

what are the 4 types of VAD

A

pneumatic
electric or electromagnetic
axial flow
centrifugal

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34
Q

what is the main concern with VAD

A

pump thrombus formation

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35
Q

what can be used with VAD when the lungs fail to oxygenate

A

ECMO

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36
Q

pulmonary edema is known as

A

decompensated heart failure

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37
Q

what occurs with pulmonary edema

A

L ventricle fails, blood backs up into lungs

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38
Q

does pulmonary edema occur quickly or slowly

A

can be either

quickly is known as flash pulmonary edema

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39
Q

s/sx of pulmonary edema

A

restless
anxious
sudden SOB
sense of suffocation
tachypenic with low O2 SAT
cyanotic, pale
cool, clammy
JVD
tachycardia
confusion
increase quantities of foamy sputum

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40
Q

what is infective endocarditis (IE)

A

infection of endotheial surface (endocardium)

injury leads to clot formation, infection invades clot, invaded clot continues to expand and concealed by bodies natural defenses

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41
Q

IE is commonly caused by which bacterias

A

staph
strep

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42
Q

s/sx of IE

A

fever, chills
weakness, malaise, fatigue
anorexia, weight loss
abdominal discomfort
clubbing
HA
arthralgia
dyspnea
CP
sharp LUQ pain, spleenomegaly
flank pain, hematuria
decrease LOC

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43
Q

vascular s/sx of IE

A

splinter hemorrhages
petechia
osler nodes
janeway lesions
roth’s spots

44
Q

what are osler nodes

A

small, painful nodules on pad of fingers, toes

45
Q

what are janeway lesions

A

irregular, red or purple, painless flat macules on palms, fingers, hands, soles, toes

46
Q

what are roth’s spots

A

hemorrhage with pale centers causes by emboli observed in fundi of eye

47
Q

what s/sx to monitor for with IE

A

s/sx of stroke

48
Q

to Dx IE, pt must have 2+ of which 3 tests

A

2 positive blood cultures 12 hours apart
intracardial mass, vegetation on echo
TEE

49
Q

what is needed prior to dental procedures to prevent IE after a heart transplant

A

prophylactic abx

50
Q

what is myocarditis

A

inflammation of myocardium

51
Q

what can causes myocarditis

A

viral, bacterial infections
fungi
radiation induced
chemical, pharmacological agents

52
Q

what is the most common cause of myocarditis

A

coxsackie A & B virus

53
Q

early s/sx of myocarditis

A

fever
fatigue, malaise
pharyngitis
dyspnea
N/V
lymphadenopathy

54
Q

what occurs with myocarditis 7-10 days after viral infection

A

effusion
pericardial friction rub

55
Q

late s/sx of myocarditis

A

CHF
JVD
S3
syncope
angina
peripheral edema

56
Q

only definitive way to Dx myocarditis

A

MRI

57
Q

other ways to Dx myocarditis

A

EKG with ST changes
elevated WBC, CRP, ESR

58
Q

myocarditis treatment

A

abx
limit physical activity
TED hose

59
Q

Can a person with myocarditis take NSAIDS

A

No

60
Q

what to monitor for if a person has myocarditis and takes digoxin

A

digitalis toxicity

new arrhythmia, A/N/V, HA, malaise

61
Q

what is pericarditis

A

pericardial inflammation

62
Q

what is the cause of pericarditis

A

unknown but may be viral, bacterial, or fungal

63
Q

when does acute pericarditis occur

A

48-72 hours post MI

64
Q

what occurs with acute pericarditis

A

sac inflamed > leaks fluid (pericardial effusion)

65
Q

what is Dressler syndrome

A

pericarditis that occurs 4-6 weeks after MI

late pericarditis

66
Q

what test is used to confirm pericarditis

A

EKG

67
Q

pericarditis s/sx

A

severe, sharp CP with deep inspiration and lying flat (pain can radiate to neck, L shoulder and upper back)

dyspnea
pericardial friction rub

68
Q

hallmark s/sx of pericarditis

A

pericardial friction rub

69
Q

when is pericardial friction rub heard best with pericarditis

A

holding breath while leaning forward

70
Q

what position is used to relieve pericarditis CP

A

sitting up, leaning forward

71
Q

pericarditis complications

A

pericardial effusion
cardiac tamponade
Becks Triad
pulseless paradox

72
Q

what is pulseless paradox

A

drop in BP by 10 mmHg with inspiration

must note the pressure heard on expiraiton

73
Q

pericarditis treatment

A

pericardiocentesis
abx
tx underlying cause
NSAIDS
corticosteroids
colchine

74
Q

what occurs with mitral stenosis

A

decrease blood from from L atrium to L ventricle

causes a pressure difference during diastole

75
Q

mitral stenosis put a person at risk for which cardiac dysrhythmia

A

afib

76
Q

where is a diastolic murmur heard with mitral stenosis - 2 locations

A

L sternal border
R 2nd ICS

pt must lean forward and hold breath

77
Q

mitral stenosis s/sx

A

SOB with exertion
loud S1 murmur
hemoptysis
CP
emboli
fatigue
palpitations
hoarseness

78
Q

mitral stenosis treatment

A

surgical splinting
valve replacement
inoue technique

79
Q

what is mitral regurgitation

A

blood from from L ventricle back into L atrium

incomplete valve closure during systole

80
Q

what are the 2 types of mitral regurgitation

A

acute, chronic

81
Q

acute mitral regurgitation can lead to what if left untreated

A

cardiogenic shock

82
Q

acute mitral regurgitation s/sx

A

thready pulse
cool, clammy extremities

83
Q

chronic mitral regurgitation early vs progressive s/sx

A

early: fatigue, weak, palpitations, dyspnea

progressive: orthopnea, noctural dyspnea, peripheral edema

84
Q

an audible S3 is heard where with chronic mitral regurgitation

A

apex, sound radiates to axilla

85
Q

what is mitral valve prolapse

A

leaflet balloon back into atrium during systole

86
Q

most common valve problem

A

MVP

87
Q

does MVP occur more in women or men

A

women

88
Q

what test is used to Dx MVP

A

echo

89
Q

treatment method for MVP

A

control symptoms

avoid alcohol, caffeine, tobacco

90
Q

will a with who has MVP and CP respond to nitrates

A

No

91
Q

MVP s/sx

A

commonly asymptomatic

fatigue
SOB
lightheaded, dizzy
syncope
palpitations

92
Q

what is aortic valve stenosis

A

obstructive blood flow from L ventricle to aorta during systole

93
Q

aortic valve stenosis can lead to what

A

L ventricular hypertrophy

94
Q

aortic valve stenosis s/sx

A

angina
syncope
DOE
HF
diminished or prominent S4

95
Q

where is an S4 heard with aortic valve stenosis

A

R 2nd ICS

lean forward, exhale

96
Q

what can occur with progressive aortic stenosis

A

decrease tissue perfusion
pulmonary HTN
HF

97
Q

what occurs with atrial regurgitation

A

back flow of blood into L ventricle from aorta during diastole

98
Q

what is 2 diseases are results of atrial regurgitation

A

pulmonary HTN
R CHF

99
Q

what is a diastolic murmur heard with atrial regurgitaiton

A

3rd or 4th ICS at LSB

100
Q

what are the causes of acute atrial regurgitation

A

trauma
IE
aortic dissection (life threatening emergency)

101
Q

acute atrial regurgitation s/sx

A

abrupt onset of:
CP
dyspnea
L ventricular failure
cardiogenic shock

102
Q

chronic atrial regurgitation s/sx

A

fatigue
DOE
orthopnea
nocturnal dyspnea
water hammer pulse (Corrigan’s pulse)

103
Q

what is water hammer pulse (Corrigan’s pulse)

A

bounding, forceful pulse with rapid upstroke and descent

104
Q

which artificial valve last longer: mechanical or biological

A

mechanical

105
Q

which artificial valve requires lifelong anticoagulation therapy: mechanical or biological

A

mechanical

106
Q

how long can a biological valve last

A

7-15 years

107
Q

what are the 4 types of biological valves

A

bovine (cow)
porcine (pig)
equine (horse)
homograft/allograft (cadaver)

M/S 3 (17 decks)

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